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should I have ACDF C4-5,C5-6,C6-7

AnonymousUserAAnonymousUser Posts: 49,899
edited 06/11/2012 - 8:22 AM in Neck Pain: Cervical
Been having neck issues for years did MRI in Feb 08, it showed moderate canal to severe right neural foraminal stenosis on the above mentioned levels,disc bulging etc and straightening of the neck. :W Got a 2nd opinion and was advised need multilevel fusion. :S

I am 42 female. I dont have constant pain , but for the past 2 months my right thumb is completely numb and my arm has the falling asleep feeling 24/7 verry annoying, tinglin , numbness and shoulder pain. I wanted to know if I don't do the surgery or if I keep prolonging it will I get worse? I asked to have just a 1 level done (C5-6) which looks the worst on MRI, but the Neurosurgeon said that that would be bad because the other disc will wear off also.

Will I have no movement in my neck at all with a 3 level fusion? And does bone grafting really hurt that bad? Pleaaaase help I am really scared. :S Anyone who had succesfull multilevel ACDF Pleeease respond.

Thanks
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Comments

  • butterflye, welcome to spine-health. You've come to the right place for support and encouragement. :H

    I can't tell you if you should or should not have surgery, but I will try to answer your questions. I had a 3 level fusion (C5 to T1). At first mobility is quite restricted, but this improves with physical therapy and time. I can't put my chin to my chest, but really the only problem I have with mobility is not being able to turn my neck far enough to look over my shoulder when driving in traffic. It does get stiff, but it did that before surgery too. In my case having surgery was definitely worth it, even though I had some pretty severe complications with my first one. Pre-surgery, I had given up all activities. I still continued to work, but my employer was very patient and understanding. That last couple of weeks before surgery were the hardest, and I knew if I didn't have surgery, I would have to give up my job. Ended up doing that anyway, but that is another story.

    I am assuming you are asking about taking bone from your hip when you ask if that hurts. I used cadaver bone the first time around, and unfortunately did not fuse. 2nd time the surgeon removed 2 vertebrae and he was able to use that bone and grind it up for my graft. I have heard that the hip is painful, but my opinion is that since you are having a multi-level fusion, using your own bone would be a very wise thing to do. Multi-levels have a higher chance of having a non-union, so you'll want to make sure to do everything you can to improve the fusion process.

    It is a scary thing, but it also is something that many of us end up needing. Please be sure to ask many questions, check out your surgeon making sure that he is highly experienced doing the same surgery he is recommending for you, and make sure you have 2-3-4 opinions. Good luck to you, and feel free to ask questions here.

    Surviving chronic pain one day at a time, praying for a reprieve because living another 40 years like this doesn't sound too fun!
  • Have you tried non-surgical treatments? Surgery is scary, and wow, can it hurt, but we get through it if the benefits outweigh all that. I'm 42 also, and did multilevel ACDF this year, but with cadaver bone, which fused right away. My bigger problem six months out is mobility in my neck, and not being able to look to the right. Hopefully with enough PT and recovery time this will decrease. I don't regret the surgery - whatever pain or lack of mobility I'm working my way through now is way more manageable than the pain I experienced before. And some days, I really feel great. Good luck with your decisions - ask a lot of questions, and know that there is a community of people out here going through similar experiences - you are not alone.
  • Welcome and I also would not recommend surgery one way or the other and also agree with the others to get 2nd and 3rd opinions. I would exhaust all conservative measures first. I was one of the unlucky ones that had severe complications with failed hardware and have been left in worse shape than before surgery. In my experience surgeons can minimize the possible side effects so educate yourself. I had a re-fusion done in May of this year and they used bone from my hip. Yes it hurt!! but it was worth it. I had to use a walker for the first four days and it still aches but I have a much better chance of fusing this time. My doctor compared it to a broken bone, the pain and healing is the same.

    I had a fusion c5-7 and my worst level was also c 5-6 with many issues down my right arm as well. Have you tried epidural shots? I've had several over the years and always experienced great relief of symptoms.

    The best advise is to make sure you talk to several neurosurgeons and be very comfortable with the one you choose. Ask a lot of questions especially about the hardware they use and how they track the fusion process. Best of Luck to you, and I'd be happy to answer any other questions. I'll say a prayer for you.
    ~Jan
  • I think we have several of the same things, and I have not had surgery. My problems began with severe arm/shoulder pain. I was shocked to find out my neck was the problem! I have pain ever now and then. My ROM is also effected. But, I look at surgery as a last resort. I am more careful than I used to be. I will need multi-level, but the nuerosurgeons advised me to wait. I'm 54. Be sure to get several opinions and do lotsa research. There are plenty surgery success stories here on SH, and I have learned so much from the folks here. Welcome!--Mazy
  • Hi,

    Thank you for your message. Yeah, I am thinking about a 3rd opinion, but the Neurosurgeon I saw this time is pretty good, he explained everything and even offered to explain it again, wanted me to talk to friends and familie, people that have had the surgery and he even told me that about one one guy that he operated on that woke up and could not use his right arm :jawdrop: He encouraged as many opinions as I wanted.

    I liked that a lot , He was very honest and he has been doing this for 18 years, so I guess he is pretty good.

    I am making a list of questions and will fire them at him when I go for a 2nd consult with my Husband.

    Thank you so much.
  • Hey Jan,

    I actually had 2nd opinion, I should have put in my message that I have been dealing with back and neck pain eversince I was 12. I don't know if i was born with these bone issues. My neck is straight and no lordisis and been like this for years
    I think that I've had spondylosis for years but no one discovered it until the MRI I did in '04 at that time I was 38.

    I have had physical therapy seen a chiropractor,jada jada jada but was told by the first NS not to have any manipulation done to my neck.

    This is because I have these electrical shocks down my spine sometimes. The GP said that it was good but the NS said that it was very bad for me to have those :W Go figure.

    I know God will work this one out for me. Thanks for you prayers. :)

  • Hi Mazy,

    Thank you, I am a lot more confident now by reading every ones response. I did the sane thing when I had to have my Hystorectomy. It really helps.

    Thanks

    ________________

    __________________________
    Cervical and lumbar DDD,Cervival spondylosis,Stenosis,.Mild Myelopathy,severe right neural foraminal stenosis level c4-5, c5-6,c6-7,moderate canal stenosis, Osteophytes. Surgeries: Hysterectomy '05, carpal tunnel left and right 1/08 and 4/08, Trigger release 4/08
  • I had a cervical fusion of C5-C7 two years ago and they used bone out of my hip, after the surgery I felt hardly no pain in my neck, stiffness from having it in the brace for so long. The hip area hurt while it was healing, but the pain meds and taking it easy helped, I also walked with a cane for a couple of weeks which helped alot. In April I had to have a 2nd surgery on level C7-T1 due to a leak in the disk causing problems, so my opinion would be to let them take care of all the issues now or you will probably be looking at another surgery shortly.
  • Thanks snuggles.

    Do you still have pain in your hip? Do you know if that is the only place they can take bone from?
  • i had the same levels as you done.had stenosis as well and mylopathy.i was told because i had cord compression that i needed surgery soon or i would be paralyzed. stenosis can only be fixed with surgery there is no conservative method to fix it. i'm only four months post surgery and i have a lot of movement in my neck.i've lost almost no movement and what i have lost i believe i will get back right now its because its painful and i don't push to get it farther. :)))
  • I do not have pain in my hip anymore, not that I have noticed anyway. As far as I have been told that is the only place they take it from or they use bank bone, which I have also got due to a 2nd fusion in april.
  • Hi butterflye18, I hope you make the correct decision for yourself. In my case a small health care clinic(I call them 7/11 medical clinics)doctor took xrays and sent me to PT. After a few weeks of complaining about numbness in my arms to the PT, I decided on my own to go to a good hospital ER. They did a CT, a MRI, and told me I was lucky to be alive because of the PT. I talked to 3 NS that day and was told I needed surgery ASAP. My surgery was 4 days later. My ROM is poor, but my plate goes from c3-c7. I will pray for you.
    GOD BLESS ALL
    KC
  • You said titanium implants..you mean the plate right? Did you do hip bone or bone bank? I woud like to have motion just like you.

    Did you do specific excercises? let me know.

    Thanks
  • I hate to say the same as everyone else but it is different for each of us. I like you tried to play the "do I really need it" game for a bit. My decision was made after having mri's two years apart with twice the damage as before. I knew when the dr told me now or suffer more permanate damage it was time. So I scheduled it and then second guessed myself up until the day! Our minds are great things but can really confuse us sometimes.

    Anyway best of luck to you in your decision process. It is a hard one and one only you can make with the best information possible.

    I also wanted to say and kind of ask...my neuro won't take bone out of female hips...he says due to bone thinning later in life of females. So I have cadaviar (sp?) in my multi. Has anyone else heard of this with their drs?

    PP
  • my surgeon did implants no bone in three levels . i have great motion so far and i'm sure once the pain is less it will be almost full.i'm sure in the states there not doing that many levels yet.
  • I am female and the doc took bone out of my hip. Maybe my doc didn't think of that though, I would thank your doc for thinking about your future and possible problems it may have caused for you.
  • If you have a choice for surgery, choose ADR over fusion.
  • Not possible for multi level (3 level)
  • Just wanted to let you know what I am doing. I will be fusing C5-6 and C6-7. The NS will be using small Cages (they look like little springs) in place of the disks. The tiny amount of my bone that comes out from where the screws and plate will be placed is ground up and put in the cage for fusion. My surgery takes place in September.
  • Activity modification for foraminal stenosis. If patients are not unduly troubled by foregoing a few activities and are not in a great deal of discomfort, choosing to live with the condition is a reasonable option. Delaying or avoiding back surgery is not dangerous, and back surgery may always be considered at a later date.

    I found that here:

    http://www.spine-health.com/conditions/spinal-stenosis/cervical-foraminal-stenosis

    Personally,I would only have surgery as a last resort...I say this because I've already had operations in the double digits and each one takes it's toll on the body.I have similiar symptoms to yours-thumb is numb,fingers tingle,shoulder hurts.I also have a lot of neck pain and other symptoms..went to my OS this past Tuesday and he rec. keeping up with conservative treatment.Of course we are all different and I wish you luck.

    It's a tough decision.
  • Butterflye:
    I had a C5-7 ACDF in Jan. of 2007. I went thru 5 years of a nightmare with my neck. I tried everything and ended up doing the fusion anyway. Personally, My range of motion is not bad. Side to side is pretty good. The only issue I have that is significant is that looking up is bad. I had to get a sinus CT scan and I was on my stomach with my head back somewhat. That took me a month to get over. But seriously, how often do you look up. I am finding its not that inconvenient. (on July 4th I lie down and watch the fireworks. heh). And I skip Planetariums now. I dont know what adding that extra level would do. I can still back out of a parking spot and do OK. I dont love it but its very do-able.
  • Hi. I had this exact operation on 8/24/2007. Today, 9/11/08 I am celebrating. Today I was released from my Aspen Collar (yes, over a year!)my electronic bone stimulator and have full permission to start exercising doing whatever I want as long as I start slowly.
    I am 60 and generally in excellent health with no underlying diseases.
    My reason for the surgery was different from yours. I had fallen and landed face first from a third step. But the actual surgery is the same. The surgery post-op was a breeze for me but I went into the operation paralyzed in three limbs as I had punctured my spinal cord at c6. Mine was life threatening. The doctors @ the University med cntr said I had a 15% chance of recovering. I was so excited to be able to move my limbs post-op that I vowed I would be very pro-active about the recovery. I suffered severe burning searing pain (and complete numbness)on the last three fingers of both hands, up the outside of my arms into the armpits.

    They used my hipbone for c4/5 and a cadaver knee cap to replace two discs and a vertebra which had shattered. So I am complete knee cap from C5 to C7. I have a titanium plate C4-C7.
    Hipbone fused by 6 months and kneecap by 13 months (non-union issues for which I requested an Rx for a bone stimulator).
    As I said, compared to the nerve pain in hand/fingers/arms, the surgery was a breeze.

    I cannot advise whether to have or not have surgery. All I can say is that for me having an abdominal hysterectomy was way more painful.
    Spinal fusion? Bit of morphine the first day. Yummy old Vicodin for a couple of weeks after that. Dr kept asking me "how does your hip feel?" I answered him that it felt like I had bumped it hard on a doorknob. Not an iota of neck pain either before or after the operation (except the op site for a couple of days)
    I continue on Neurontin for the nerve pain but it IS better and the sensation to my hands is nearly 70% of normal. I am patient. I WILL recover completely.

    I must be a tough old broad but I am grateful to be alive.

    Don't be afraid! Trust that it will work and concentrate on how well you will feel afterward. Start now. Once you make the decision you can use all that energy in thinking how you can use it to recover.

    p.s. As a nice bonus I dropped 23 lbs! Now I am 60, skinny and saggy.
  • Anonymous said:
    Been having neck issues for years did MRI in Feb 08, it showed moderate canal to severe right neural foraminal stenosis on the above mentioned levels,disc bulging etc and straightening of the neck. :W Got a 2nd opinion and was advised need multilevel fusion. :S

    I am 42 female. I dont have constant pain , but for the past 2 months my right thumb is completely numb and my arm has the falling asleep feeling 24/7 verry annoying, tinglin , numbness and shoulder pain. I wanted to know if I don't do the surgery or if I keep prolonging it will I get worse? I asked to have just a 1 level done (C5-6) which looks the worst on MRI, but the Neurosurgeon said that that would be bad because the other disc will wear off also.

    Will I have no movement in my neck at all with a 3 level fusion? And does bone grafting really hurt that bad? Pleaaaase help I am really scared. :S Anyone who had succesfull multilevel ACDF Pleeease respond.

    Thanks
  • Had spinal stenosis with 2 level fusion using allografts (cadaver). I live in the Denver area and had an ACDF & diskectomy on July 8th, 2010. They also repaired a slipped vertibra which I hear is common. It is almost 3 months post op and I have NO pain now. Before surgery, I was in pain every day mostly due to the myelopathy. I had stabbing pain in my R thumb joint, stifness & numbness in both hands & tingling from fingers to shoulder on R arm. I had trouble walking due to the myelophathy with constant pain from hips to toes. Went to a Denver surgeon who specialized in the cervical spine. I did not consume caffeine or smoke upon agreeing to surgery. I smoke about 2 packs of cigarettes per year. My weight is within normal range. I walked constantly after surgery as directed which accelerated my healing. My fusion took place in less than 3 months. You will have 6 weeks to get mobility back after surgery according to my phys therapist. You can get some back later but it would be much harder to do. Phys therapist said I will get back 60 to 70% of my normal range since it was a 2 level fusion. 3 level fusions would obviously get back a little less movement. This surgery is necessary once you get hand or leg symptoms because it will slow down the progression of degeneration in spine. Phys therapist & doc says most people have some pain left after surgery so I am the exception. The healing process takes time but I would do it again. Be sure to get 2 opinions & choose your surgeon carefully. I feel great & am not healing fast. I would go to someone who specializes in the cervical spine & has a high success rate. I will be glad to answer questions for anyone who has similar cervical spine issues about my own experience.
    Good luck to you if we do not chat.
  • I am 5'3" and petite, my doc said he could not do a bone graft due to my size. Said my pants would rub on my hip and cause pain so he did an allograft on me. Bone grafting is usually done since the fusion has a tendency to heal better than an allograft but my fusion took place & my surgeon said you could not tell that it was not a bone graft. I am probably the exception. Some people who have had recent surgeries have told me that they can feel the spot of the bone graft but I am told that the discomfort goes away in time. I am not sure if this helped at all but thought you might want to hear about my experience.
    Good luck to you.
    Anonymous said:
    Been having neck issues for years did MRI in Feb 08, it showed moderate canal to severe right neural foraminal stenosis on the above mentioned levels,disc bulging etc and straightening of the neck. :W Got a 2nd opinion and was advised need multilevel fusion. :S

    I am 42 female. I dont have constant pain , but for the past 2 months my right thumb is completely numb and my arm has the falling asleep feeling 24/7 verry annoying, tinglin , numbness and shoulder pain. I wanted to know if I don't do the surgery or if I keep prolonging it will I get worse? I asked to have just a 1 level done (C5-6) which looks the worst on MRI, but the Neurosurgeon said that that would be bad because the other disc will wear off also.

    Will I have no movement in my neck at all with a 3 level fusion? And does bone grafting really hurt that bad? Pleaaaase help I am really scared. :S Anyone who had succesfull multilevel ACDF Pleeease respond.

    Thanks
  • Judy,

    Howdy! I've had 2 cervical fusions, and more to come. As a smoker I've "offered" to allow them to take from my hip, and the answer I've gotten is that "now a days, there is virtually no difference in fusion rates with the quality of the graphs they use now." Before this last surgery, and new meds, I was petite, and too 5'3"...:)

    Brenda
    PCTF C4 - T2, Laminectomies C5, C6 & C7. Severe Palsy left arm/hand.
  • I am sorry to hear that you had two fusions already. Our docs just disagree. There are many opinions out there so people just need to decide what they feel comfortable with. I saw one surgeon who did not have his patients wear collars. He said that his colleagues agree that it would not make a difference in the outcome. I heard that he was one of the best surgeons in our area. However, I decided to go to someone more conservative. I am sure that every person is different regarding bone graphs too. I am curious, did your fusions eliminate all of your pain? If not, what percentage of pain do you have? I am told that it takes 18 months before a final determination can be made about the outcome. I am pain free at this point but will wait to see if anything comes up. After all, I am not even 3 months postop.

    Thanks O:)

    Judy
  • I am sorry to hear that you had two fusions already. Our docs just disagree. There are many opinions out there so people just need to decide what they feel comfortable with. I saw one surgeon who did not have his patients wear collars. He said that his colleagues agree that it would not make a difference in the outcome. I heard that he was one of the best surgeons in our area. However, I decided to go to someone more conservative. I am sure that every person is different regarding bone graphs too. I am curious, did your fusions eliminate all of your pain? If not, what percentage of pain do you have? I am told that it takes 18 months before a final determination can be made about the outcome. I am pain free at this point but will wait to see if anything comes up. After all, I am not even 3 months postop.

    Thanks O:)

    Judy
  • You're so right about different doctors, and too different methods to hopefully get to the same 'end game.' :)

    My first fusion I was 100% pain free when I woke up! I actually cried in the recovery room! I was moving my arm around pain free - before the surgery even lifting my arm up 45 degrees - sering pain all through it. Neck pain, shoulder pain, was all gone - hence the tears. Heck, the nurse came running over asking if I needed medication for the pain I was obviously (to her) in. I told her, no, no pain, just happy tears!

    My second (adjacent level failure) neck fusion was not as good. I woke up and most of the pain was gone, but the weakness, and numbness was still there. I seemed to be getting some of my strength back by around week 5, but by week 7 lost it all. They did an MRI, but 8 weeks out of surgery, I still had a lot of swelling there. Most of all my pains and weakness came back around month 6 to include losing my voice. X-rays showed the bone between the fusions cracked, and my ENT confirmed that area is now moving.

    So, I am kinda back before square 1. Next week I am back with my GP (I decided to start over with new Neurologists and surgeon) to get all the testing redone, MRI's, X-rays etc. I'm gonna ask for a 3D CT scan as well. If I hadn't had the next level fail, I believe I would still be pain free as I was after my first fusion. I had almost forgotten I had spinal surgery until the level went. I hope you continue along with the great results you are experiencing. Adjacent level isn't that common, I just pulled the short straw I guess! (G)

    If I can help in any way, just ask away. :) I know if I don't have the answer, someone on here probably will. Congratulatory *HUGZ* on your progress!!!

    Brenda
    PCTF C4 - T2, Laminectomies C5, C6 & C7. Severe Palsy left arm/hand.
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